با همکاری مشترک دانشگاه پیام نور و انجمن عصب روان‌شناسی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دکترای روان‎شناسی تربیتی، دانشگاه تهران، تهران، ایران.

2 کارشناس ارشد هنر اسلامی، دانشگاه علم و فرهنگ، تهران، ایران.

3 کارشناس صنایع دستی، دانشگاه هنر، تهران، ایران.

4 کارشناس ارشد روانشناسی عمومی، دانشگاه پیام نور، تهران، ایران.

5 کارشناس ارشد روانشناسی عمومی، دانشگاه آزاد اسلامی واحد علوم و تحقیقات، تهران، ایران.

10.30473/clpsy.2025.73558.1772

چکیده

هدف: اختلال نقص‎توجه-بیش‎فعالی(ADHD) یکی از شایع‎ترین اختلالات عصبی-رشدی است که با علائم بی‎توجهی، بیش‎فعالی و تکانشگری مشخص می‎شود. این پژوهش با هدف مقایسه اثربخشی برنامه آموزشی فراتفکر مبتنی بر شبیه‎سازی ذهنی-مغزی (MTMBS) و هنردرمانی با گِل رُس(CAT) بر بهبود تنظیم هیجان در نوجوانان مبتلا به ADHD انجام شد. روش: این مطالعه یک کارآزمایی بالینی کنترل شده تصادفی از نوع نیمه‎آزمایشی بود که در آن 45 نوجوان مبتلا به ADHD به طور تصادفی در سه گروه آزمایش و کنترل قرار گرفتند. برای جمع آوری داده‎ها از پرسشنامه دشواری تنظیم هیجان گراتز و رومر (2004) و پرسشنامه درجه‎‌بندی کانرز فرم والدین(1978) استفاده شد. مداخلات آموزشی به مدت 8 و 16جلسه 90 دقیقه‎ای اجرا شدند. تحلیل داده‎ها با استفاده از تحلیل کوواریانس چندمتغیری و آزمون تعقیبی بنفرونی انجام شد. یافته‏ ها: نتایج نشان داد که هر دو رویکرد درمانی در بهبود تنظیم هیجان نوجوانان مبتلا به ADHD اثربخش بودند. تجزیه و تحلیل کوواریانس چندمتغیری نشان داد که 80 تا 83 درصد از تغییرات در مؤلفه‌های تنظیم هیجان تحت تأثیر مداخلات درمانی قرار داشت(0.05>P). با این حال، تفاوت معناداری در اثربخشی دو روش درمانی مشاهده نشد(0.05<P). نتیجه‌گیری: براساس یافته‌های بدست آمده هر دو رویکرد درمانی به طور یکسان در بهبود تنظیم هیجان نوجوانان مبتلا به ADHD مؤثر هستند. این نتایج پیامدهای مهمی برای ارائه مداخلات درمانی مبتنی بر شواهد برای این گروه از بیماران دارد و می‌تواند به بهبود کیفیت زندگی و سلامت روان آن‎ها کمک کند.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Comparison of the Effectiveness of the Meta-thinking Training Program based on Mental-Brain Simulation and Clay Art Therapy on the emotion regulation of adolescents with Attention Deficit- Hyperactivity Disorder (ADHD): A Randomized Controlled Clinic

نویسندگان [English]

  • Abed Mahdavi 1
  • Manijeh Noori 2
  • Ladan Valizadeh Davoodabadi 3
  • Hoda Ghoraeian 1
  • Zahra Ramezanpour Sobhani 4
  • Yaser Heidari 1
  • Ebtesam Farajollahzadeh 5

1 PhD in Educational Psychology, University of Tehran, Tehran, Iran.

2 MA of Islamic Arts, University of Science and Culture, Tehran, Iran.

3 BA of Handicraft Art, Tehran University of Art, Tehran, Iran.

4 MA of General Psychology, Faculty of Psychology and Education Sciences, Payame Noor University, Tehran, Iran.

5 Department of Psychology, Islamic Azad University, Science and Research Branch, Tehran, Iran.

چکیده [English]

Purpose: Attention hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders characterized by symptoms of inattention, hyperactivity, and impulsivity. The study compared the effectiveness of the Meta-thinking Training Program based on Mental-Brain Simulation (MTMBS) and Clay Art Therapy (CAT) in improving emotion regulation in adolescents with ADHD. Method: This study was a randomized controlled clinical trial of the semi-experimental type in which 45 adolescents with ADHD were randomly placed in three Test and control groups. The emotion regulation difficulty questionnaire of Graz and Romer (2004) and the Connors parenting form grading questionnaire (1978) were used to collect data. The training intervention of both methods was implemented for eight and sixteen sessions of 90 minutes. The data analysis was performed using multivariate covariance analysis and a Bonferroni test. Findings: The results indicated that both therapeutic approaches significantly improved emotion regulation in adolescents with ADHD. A multivariate covariance analysis revealed that the therapeutic interventions accounted for 80 to 83 percent of the changes in various components of emotion regulation. However, Statistical evaluation indicated no significant variance in effectiveness between the treatments. Conclusion: Based on the findings, both therapeutic approaches are equally effective in improving the emotion regulation of adolescents with ADHD. These results have important implications for providing evidence-based therapeutic interventions for this group of patients and can help improve their quality of life and mental health.

کلیدواژه‌ها [English]

  • Meta-thinking
  • Mental-Brain Simulation
  • Clay
  • Emotion Regulation
  • ADHD
Ayano, G., Demelash, S., Gizachew, Y., Tsegay, L., & Alati, R. (2023). The global prevalence of attention deficit hyperactivity disorder in children and adolescents: An umbrella review of meta-analyses. Journal of affective disorders339, 860–866. https://doi.org/10.1016/j.jad.2023.07.071
Bae, Y. S., & Kim, D. H. (2018). The Applied Effectiveness of Clay Art Therapy for Patients with Parkinson's Disease. Journal of evidence-based integrative medicine, 23,2515690X18 765943.
Barkley, R. A. (2015). Comorbid psychiatric disorders and psychological maladjustment in adults with ADHD. In: Barkley RA, editor. Attention-deficit hyperactivity disorder, fourth edition. New York: Guilford Publication.
Barkley, R. A., & Fischer, M. (2010). The unique contribution of emotional impulsiveness to impairment in major life activities in hyperactive children as adults. Journal of the American Academy of Child and Adolescent Psychiatry49(5), 503–513. https://doi.org/10.1097/00004583-201005000-00011
Barkley, RA. (2015). Emotional dysregulation is a core component of ADHD. In: Barkley RA, editor. Attention deficit hyperactivity disorder, fourth edition. New York: Guilford Publication.
Beheshti, A., Chavanon, M. L., & Christiansen, H. (2020). Emotion dysregulation in adults with attention deficit hyperactivity disorder: a meta-analysis. BMC psychiatry, 20(1), 120.
Biederman, J., Spencer, T.J., Petty, C., Hyder, L., O’Connor, K.B., Surman, C.B.H., & Faraone, S.V. (2012). Longitudinal course of deficient emotional self-regulation CBCL profile in youth with ADHD: Prospective controlled study. Neuropsychiatr Dis Treat, 8, 267–276.
Bob, P., & Privara, M. (2025). ADHD, stress, and anxiety. Frontiers in Psychiatry, 16, 1536207. https://doi.org/10.3389/fpsyt.2025.1536207
Bob, P., Konicarova, J., & Raboch, J. (2021). Disinhibition of Primitive Reflexes in Attention Deficit and Hyperactivity Disorder: Insight into Specific Mechanisms in Girls and Boys. Frontiers in psychiatry12, 430685. https://doi.org/10.3389/fpsyt.2021.430685
Bunford, N., Evans, S. W., & Wymbs, F. (2015). ADHD and Emotion Dysregulation Among Children and Adolescents. Clinical child and family psychology review18(3), 185–217.
Christiansen, H., Hirsch, O., Albrecht, B., & Chavanon, M. L. (2019). Attention-Deficit/Hyperactivity Disorder (ADHD) and Emotion Regulation Over the Life Span. Current psychiatry reports21(3), 17.
Elbrecht, C., & Antcliff, L.R. (2014). Being touched through touch, Trauma treatment through haptic perception at the clay field: a sensory-motor art therapy. Int J Art Ther, 19:19-30.
Goldstein S., Naglieri J. A. (2014). Handbook of executive functioning. Springer Science Business Media.
Goyette, C. H., Conners, C. K., Ulrich, R. F. (1978). Normative data on revised Conners parent and teacher rating scales. Journal of Abnormal Child Psychology, 6, 221–236.
Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 41–54.
Gurley, J.R. (2011). Conners’ Parent Rating Scales – Revised. In: Goldstein, S., Naglieri, J.A. (eds) Encyclopedia of Child Behavior and Development. Springer, Boston, MA. https://doi. org /10.1007/978-0-387-79061-9_670
Henley, D. (2002). Clay works in Art Therapy: Plying the Sacred Circle. London, England: Jessica Kings ley.
Hinz, L. D. (2009). Expressive therapies for adolescents. Routledge.
Hu, J., Zhang, J., Hu, L., Yu, H. & Xu, J. (2021). Art Therapy: A Complementary Treatment for Mental Disorders. Front. Psychol. 12:686005. DOI: 10.3389/fpsyg.2021.686005
Kenézlői, E., Balogh, L., Somogyi, S., Lévay, E. E., Halmai, Z., Nemoda, Z., Unoka, Z. S., & Réthelyi, J. M. (2025). Emotion dysregulation and impulsivity as overlapping symptoms in adult Attention-Deficit/Hyperactivity Disorder and Borderline Personality Disorder: severity profiles and associations with childhood traumatization and personality functioning. Annals of general psychiatry24(1), 3. https://doi.org/10.1186/s12991-024-00540-y
Kermani Mamazandi, Z., & Tale Pasand, S. (2018). Psychometric Characteristics of Difficulties in Emotion Regulation Scale in Semnan University Students. Journal of Instruction and Evaluation11(42), 117-142.
Kondi, K., Takács, M., Kovács-Posta, E. & et al. (2025). Emotion dysregulation in adolescents is normalized by ADHD pharmacological treatment. bord personal disord emot dysregul, 12(3), 1-13. https://doi.org/10.1186/s40479-024-00268-x
Li, N., Zhao, J., & Zhou, F. (2025). The burden of attention deficit hyperactivity disorder and incidence rate forecast in China from 1990 to 2021. Frontiers in Psychiatry, 16, 1532156. https://doi.org/10.3389/fpsyt.2025.1532156
Ludlow, A. K., Garrood, A., Lawrence, K., Gutie´rrez, R. (2014).  Emotion recognition from dynamic emotional displays in children with ADHD. Journal of Social and Clinical Psychology, 33(5):413–427.
Mahdavi, A., & Elaheh, H. (2024). Emotion Regulation in individuals with ADHD: A clinical guide. IntechOpen. doi: 10.5772/intechopen.1006053
Mahdavi, A., Mansureh, H.-H., Masoud, G.-A. L., Elaheh, H., Mohammad-Hossein, N. H. K., Yamin, B. D., & Abdol-Hossein, V. (2023). Construction of Meta-Thinking Educational Program Based on Mental-Brain Simulation (MTMBS) and Evaluating its Effectiveness on Executive Functions, Emotion Regulation, and Impulsivity in Children with ADHD: A Resting-State Functional MRI Study. Journal of Attention Disorders. https://doi.org /10.1177/10870547 231155436
Malchiodi, CA. (2013). Creative Art Therapy: Brain-Wise Approaches to Violence. Psychology Today. Retrieved September 9, 2013, from https://www.psychologytoday.com/us/blog/arts-and health/ 201309/ creative-art-therapy-and-attachment-work
Michal Sholt, MA., & Tami Gavron, MA. (2006) Therapeutic Qualities of Clay-work in Art Therapy and Psychotherapy: A Review. Art Therapy, 23:2, 66-72, DOI: 10.1080/07421656.2006 .1012964
Moon, B. L. (2002). Art therapy and the process of change: Creating pathways to growth and development. Charles C Thomas Publisher.
Morais, AH., Roecker, S., Salvagioni, DAJ., Eler, GJ. (2014). Significance of clay art therapy for psychiatric patients admitted in a day hospital. Invest Educ Enferm, 32(1): 128-138.
Morris, S. S. J., Musser, E. D., Tenenbaum, R. B., Ward, A. R., Martinez, J., Raiker, J. S., Coles, E. K., & Riopelle, C. (2020). Emotion Regulation via the Autonomic Nervous System in Children with Attention-Deficit/Hyperactivity Disorder (ADHD): Replication and Extension. Journal of abnormal child psychology, 48(3), 361–373.
Murray, A., Thye, M., Obsuth, I., Cai, S., Lui, M., Orr, C., & Saravanan, A. (2025). A Narrative Review to Identify Promising Approaches for Digital Health Interventions to Support Emotion Regulation for Adolescents with Attention-Deficit/Hyperactivity Disorder. JMIR Ment Health, 12: e56066. DOI: 10.2196/56066
Musella, K. E., & Weyandt, L. L. (2022). Attention-deficit hyperactivity disorder and youth’s emotion dysregulation: A systematic review of fMRI studies. Applied Neuropsychology: Child12(4), 353–366. https://doi.org/10.1080/21622965.2022.2119142
Nan, J.K.M., Ho, R.T.H. (2017). Effects of clay art therapy on adult’s out patients with major depressive disorder: a randomized controlled trial. J Affect Disord, 217: 237-245.
Nan, JKM., & Wong, WWT. (2021). A qualitative analysis of a clay art therapy project in enhancing emotion regulation among secondary school youth in the context of socio-political unrest. Journal of Clinical and Developmental Psychology, 3(1): 27‐44.
Öhman J. I. K. & Asaba, E. (2009). Goal setting in occupational therapy: a narrative study exploring theory and practice in psychiatry. World Federation of Occupational Therapists Bulletin, 60(1): 22–28.
Park, S. (2009). Goal setting in occupational therapy: a client-centred perspective In: Duncan EAS, ed. Skills for Practice in Occupational Therapy. 4th ed. Edinburgh, Scotland: Churchill Living stone / Elsevier,105-122.
Poznyak, E., & Debbané, M. (2025). Emotion regulation beyond executive and attention difficulties: impact on daily life impairments in community adolescents. Child Adolesc Psychiatry Ment Health, 19, 47. https://doi.org/10.1186/s13034-025-00898-1
Riley, S. (2001). Contemporary art therapy with adolescents. Jessica Kingsley Publishers.
Samsami, S. (2012). Prevalence of attention deficit/hyperactivity disorder symptoms in first-grade primary school children in Neyriz city and comparison of sensory processing abilities and motor skills of children with normal children. [MSc Thesis], Educational Psychology, Ferdowsi University of Mashhad.
Shahaeian, A., Shahim, S., Bashash, L., Yousefi, F. (2007). Normalization, factor analysis, and reliability of short form for parents, Connors rating scale for children aged 6-11 years in Shiraz. Quarterly Journal of Psychological Studies, 3(3), 97–120.
Shannon, N, & Frischherz, B. (2020). Metathinking: The Art and Practice of Transformational Thinking. [Pages; 23-27]: Springer, Cham. https://doi.org/10.1007/ 978 -3-030-41064-3
Sjöwall, D., & Thorell, L.B. (2019). A critical appraisal of the role of neuropsychological deficits in preschool ADHD. Child neuropsychology: a journal on normal and abnormal development in childhood and adolescence25(1), 60–80.
Soler-Gutiérrez, AM., Sánchez-Carmona, A.J., Albert, J. et al. Emotion processing difficulties in ADHD: a Bayesian meta-analysis study. Eur Child Adolesc Psychiatry (2025). https://doi.org/10.1007/ s00787-025-02647-3
Spencer, T., Faraone, S.V., Surman, C., Petty, C., Clarke, A., Batchelder, H., Wozniak, J., & et al. (2011). Towards defining deficient emotional self-regulation in youth with attention deficit hyperactivity disorder using the child behavior checklist: A controlled study. Postgrad Med J, 123(5), 50–59.
Suputtitada, P. (2021). Clay Art Therapy for Physical, Psychological and Cognitive Improvement. International Journal of Medical Science and Current Research, 4(4), 399-401.
Symons, J., Clark, H., Williams, K., Hansen, E., Orpin, P. (2011). Visual art in physical rehabilitation: experiences of people with neurological conditions. Br J Occup Ther, 74;44-52.
Tehrani-Doost, M., Noorazar, G., Shahrivar, Z., Banaraki, A. K., Beigi, P. F., Noorian, N. (2016). Is emotion recognition related to core symptoms of childhood ADHD? J Can Acad Child Adolesc Psychiatry, 26(1):31– 38.
Tenenbaum, R. B., Musser, E. D., Morris, S., Ward, A. R., Raiker, J. S., Coles, E. K., & Pelham, W. E., Jr (2019). Response Inhibition, Response Execution, and Emotion Regulation among Children with Attention-Deficit/Hyperactivity Disorder. Journal of abnormal child psychology47(4), 589–603.